Increased platelet reactivity after heart transplantation
Key result
High on-treatment platelet reactivity to aspirin and clopidogrel was present in 18% and 37% of heart transplant patients, respectively, with no difference by cardiac allograft vasculopathy status.
Why the study?
The role of antiplatelet therapy after heart transplantation is unclear, despite ex-vivo evidence of platelet hyperaggregability and findings linking early aspirin to improved survival and lower rates of cardiac allograft vasculopathy.
What is the prevalence of high on-treatment platelet reactivity to aspirin and clopidogrel in heart transplant recipients?
Population
76 heart transplantation patients on aspirin and/or clopidogrel undergoing coronary angiography
Comparison
Aspirin vs clopidogrel on-treatment platelet reactivity
Authors
Discussion
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Member takes
Implication
Should not yet change antiplatelet practice after HT; leaves open whether HPR predicts CAV or warrants function-guided therapy.
Study Design
Type
Cross-Sectional (n=76)
Structured PICO
What is the prevalence of high on-treatment platelet reactivity to aspirin and clopidogrel in heart transplant recipients?
P
Population
76 heart transplant patients on aspirin and/or clopidogrel who underwent coronary angiography, assessed at a median of 4.6 years post-transplant.
E
Exposure
Aspirin and/or clopidogrel therapy (patients with high on-treatment platelet reactivity to aspirin were switched to clopidogrel for 7 days)
O
Outcome
Prevalence of high on-treatment platelet reactivity (HPR) to aspirin (aspirin reaction unit > 550) and clopidogrel (P2Y12 reaction unit > 208)surrogate
Heart transplant recipients exhibit a high prevalence of high on-treatment platelet reactivity to aspirin and clopidogrel, comparable to patients with coronary artery disease.
Cite This Study
Aleksova et al. (2020) conducted a cross-sectional in Heart transplantation (n=76). Aspirin and clopidogrel was evaluated on Prevalence of high on-treatment platelet reactivity (HPR) to aspirin and clopidogrel. High on-treatment platelet reactivity to aspirin and clopidogrel was present in 18% and 37% of heart transplant patients, respectively, with no difference by cardiac allograft vasculopathy status.